Haematological Tests

Question 1

What is measured in iron studies?

Answer 1

• Serum Iron
• Total Iron binding capcity
• Serum Ferritin

Question 2

What are the following?

Answer 2

Acanthocytes - spicules on RBCs, due to RBC membrane lipid structure

Question 3

What are causes of acanthocytes?

Answer 3

• Splenectomy
• Alcoholic liver disease
• Spherocytosis
• Haemoglobinopathy

Question 4

What can cause blast cells in plasma?

Answer 4

• Myelofibrosis
• Leukaemia
• Malignant bone marrow infiltration

Question 5

What is the following?

Answer 5

Basophilic stippling - denatured RNA found in RBCs, indicating accelerated erythropeises of defective Hb synthesis

Question 6

What can cause Basophilic stippling?

Answer 6

• Lead poisoning
• Megaloblastic anaemia
• Leukaemia
• Malignant infiltration

Question 7

What are the following?

Answer 7

Cabot rings - thin, red-violet staining, threadlike strands in the shape of a loop or figure-8 that are found on rare occasions in red blood cells (erythrocytes)

Question 8

What are causes of cabot rings?

Answer 8

• Pernicious anaemia
• Lead poisoning
• Bad infections

Question 9

What is the following?

Answer 9

Howell jolly bodies - DNA nuclear remanats in RBCs, which are normally removed by the spleen

Question 10

What are causes of Howell-Jolly Bodies?

Answer 10

• Post-splenectomy
• Hyposplenism
• Myelodysplasia
• Megaloblastic anaemia

Question 11

What is the following?

Answer 11

Hypochromia - less dense staining of RBCs caused by decreased Hb synthesis

Question 12

What is the following?

Answer 12

Poikilocytosis - variation in RBC shape

Question 13

What are causes of poikilocytosis?

Answer 13

• IDA
• Myelofibrosis
• Thalassemia

Question 14

What are the following?

Answer 14

Reticulocytes - Young, large RBCs signifying active erythropoeisis

Question 15

When might you see reticulocytosis on blood film?

Answer 15

• Haemolysis
• Haemorrhage
• If B12, folate or iron given to marrow that lack these nutrients

Question 16

What are the following?

Answer 16

Spherocytes - spherical cells found in hereditary spherocytosis and autoimmune haemolytic anaemia

Question 17

What are the following?

Answer 17

Rouleaux formation - red cells stacked on each other, causing a rasied ESR

Question 18

What can cause rouleaux formation?

Answer 18

• Chronic inflammation
• Paraproteinaemia
• Myeloma

Question 19

What are the following?

Answer 19

Schistocytes - Fragmented RBCs sliced by fibrin bands, in intravascular haemolysis

Question 20

What are causes of schistocytes?

Answer 20

Microangiopathic anaemia

• DIC
• Haemolytic uraemic syndrome
• TTP
• Pre-eclampsia

Question 21

What causes increased neutrophil count (neutrophilia)?

Answer 21

• Bacterial infections
• Inflammation
• Myeloproliferative disorders
• Drugs
• Disseminated malignancy
• Stress - trauma, surgery, burns

Question 22

What are causes of decreased neutrophil count (neutropenia)?

Answer 22

• Viral infections
• Drugs - post chemo, cytotoxic agents, carbimazole
• Severe sepsis
• Neutrophil antibodies - SLE
• Hypersplenism - felty’s syndrome
• Bone marrow failure

Question 23

What causes increased lymphocyte count?

Answer 23

Lymphocytosis

• Acute viral infection
• Chronic infections - TB, brucella, syphilis
• Leukaemias - esp. CLL
• Lymphomas

Question 24

When might you see a decreased lymphocyte count?

Answer 24

• Steroid therapy
• SLE
• Uraemia
• Legionnaire’s Disease
• HIV infection
• Marrow infiltration
• Post-chemo/radiotherapy

Question 25

What could cause eosinophilia?

Answer 25

* **Drug reaction** * **Allergies** - asthma, atopy * **Parasitic infection** * **Skin disease** * **Malignant disease** * **Adrenal insufficiency** * **Irradiation**

Question 26

What causes Monocytosis?

Answer 26

* **Post chemo/radiotherapy** * **Chronic infections** * **Malignant disease** * **Myelodisplasia**

Question 27

What is the prothrombin time?

Answer 27

Along with its derived measures of prothrombin ratio (PR) and international normalized ratio (INR)— PT assays evaluate the extrinsic pathway of coagulation. They are used to determine the clotting tendency of blood, in the measure of warfarin dosage, liver damage, and vitamin K status

Question 28

Which clotting pathway does the PT look at?

Answer 28

Extrinsic Pathway

Question 29

Which pathway does the APTT look at?

Answer 29

Intrinsic pathway

Question 30

What is the APTT?

Answer 30

**Activated partial thromboplastin time (aPTT or APTT)** Partial thromboplastin time (PTT) measures the overall speed at which blood clots by means of two consecutive series of biochemical reactions known as the "intrinsic" (now referred to as the contact activation pathway) and common coagulation pathways.

Question 31

What is ESR a measure of?

Answer 31

**Time taken for blood to sediment at bottom of tube if left to stand** - heavier the blood, the quicker the sedimentation rate

Question 32

Why might ESR increase?

Answer 32

**Inflammatory/Autoimmune conditions which increase fibrinogen or IgG production** - causes red cells to clump together